Sr Director, Pharmacy Analytics Anywhere in the U.S. at Alignment Health

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

Reporting to the VP, Healthcare Economics, the Sr. Director of Pharmacy Analytics will be responsible for Part D financial analytics and actuarial modeling.
The Sr. Director of Pharmacy Analytics will be responsible for leading efforts to create internal and external transparency on Part D financial performance and forecasts. This leader will collaborate with finance, pharmacy, product, other internal stakeholders, external vendors, and consultants. The Sr. Director of Pharmacy Analytics will work closely with company executives and key stakeholders to develop a comprehensive plan on Part D regulatory changes as it relates to product positioning and cost savings initiatives

General Duties/Responsibilities (May include but are not limited to):

• Estimate Part D-related monthly accruals (e.g., DIR, risk corridor, etc.) and explain drivers of month-over-month variation as well as variances from budget.
• Develop and maintain actuarial and financial forecast models for Part D.
• Cross functional collaboration on Part D financial and operation strategies. This would include but not limited to formulary strategy, trend/seasonality analytics, Medical Loss Ratio (MLR) and profitability projections, financial implications of new drugs entering the market, regulatory impact analyses and benchmarking competitive intelligence.
• Lead the development and review of Part D bid assumptions with our external Pharmacy Benefits Management (PBM) vendor and review of projection results with our external actuarial vendor.
• Lead review of PBM performance and identify areas of opportunity for financial and operational improvement.
• Performs special projects as assigned.

Job Requirements:

Required: 8+ years of actuarial experience and preferred at least 5 years Part D experience

Education:

Required:

• Bachelor’s degree required.  Preferably in Actuarial Science, Economics, Statistics, Finance or other quantitative field
• Associate of the Society Actuaries (ASA)

Preferred: Fellow of the Society of Actuaries (FSA)

Specialized Skills:

• Effective communicator with excellent written and verbal communications. Ability to write executive level documents and make executive level presentations.
• Demonstrated ability to effectively manage multiple, diverse and/or complex projects and deadlines.
• Strong team player, ability to work within and lead cross-functional teams.
• Ability to negotiate and resolve complex and sensitive issues with diplomacy and persuasiveness.
• Ability to operate independently to navigate organizational complexities and to obtain resources needed to move initiatives forward
• Strong sense of market priorities and ability to appropriately push back against group think that will negatively impact company position in marketplace or marketability of the portfolio
• Ability to develop and lead cross divisional processes and clearly articulate complex information to achieve common goals

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay Range: $149,882.00 - $224,823.00

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

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